AI Article Synopsis
- The study compares the use of carbon fibre nails to titanium nails for intramedullary fixation in oncology patients with pathological long-bone fractures, assessing the surgical characteristics and short-term outcomes of both options.
- A total of 72 patients were included, with 36 receiving titanium nails and 36 receiving carbon fibre nails, and outcomes measured included operating time, blood loss, fluoroscopic time, and complications.
- Results indicated that carbon fibre nails had higher blood loss and longer fluoroscopic times, but fewer implant complications, suggesting that carbon fibre nails could be a viable alternative for surgical fixation in orthopedic oncology.
Article Abstract
Aims: Due to their radiolucency and favourable mechanical properties, carbon fibre nails may be a preferable alternative to titanium nails for oncology patients. We aim to compare the surgical characteristics and short-term results of patients who underwent intramedullary fixation with either a titanium or carbon fibre nail for pathological long-bone fracture.
Methods: This single tertiary-institutional, retrospectively matched case-control study included 72 patients who underwent prophylactic or therapeutic fixation for pathological fracture of the humerus, femur, or tibia with either a titanium (control group, n = 36) or carbon fibre (case group, n = 36) intramedullary nail between 2016 to 2020. Patients were excluded if intramedullary fixation was combined with any other surgical procedure/fixation method. Outcomes included operating time, blood loss, fluoroscopic time, and complications. Fisher's exact test and Mann-Whitney U test were used for categorical and continuous outcomes, respectively.
Results: Patients receiving carbon nails as compared to those receiving titanium nails had higher blood loss (median 150 ml (interquartile range (IQR) 100 to 250) vs 100 ml (IQR 50 to 150); p = 0.042) and longer fluoroscopic time (median 150 seconds (IQR 114 to 182) vs 94 seconds (IQR 58 to 124); p = 0.001). Implant complications occurred in seven patients (19%) in the titanium group versus one patient (3%) in the carbon fibre group (p = 0.055). There were no notable differences between groups with regard to operating time, surgical wound infection, or survival.
Conclusion: This pilot study demonstrates a non-inferior surgical and short-term clinical profile supporting further consideration of carbon fibre nails for pathological fracture fixation in orthopaedic oncology patients. Given enhanced accommodation of imaging methods important for oncological surveillance and radiation therapy planning, as well as high tolerances to fatigue stress, carbon fibre implants possess important oncological advantages over titanium implants that merit further prospective investigation. Level of evidence: III, Retrospective study Cite this article: 2022;3(8):648-655.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9422899 | PMC |
| http://dx.doi.org/10.1302/2633-1462.38.BJO-2022-0092.R1 | DOI Listing |
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